Wire bristle foreign body: Never in the same place twice

Abstract

Foreign body ingestion is a common reason for visiting the emergency room. Foreign bodies can lodge anywhere in the upper aerodigestive tract and can sometimes be difficult to extract. Wire bristles that dislodge from grill-cleaning wire brushes and which are then accidentally swallowed can be particularly challenging to remove due to their small size, propensity to become embedded, and their ability to migrate through tissues. This case reveals the speed with which wire bristle foreign bodies can migrate through tissues and exemplifies the need to obtain computerized tomography evaluations in close proximity to any planned attempt to remove them.

Hazards and Management of Wire Bristle ingestions: A Systematic Review

“…The final 57 studies were included in this review and used for data abstraction. 2-9,12-60 Our PRISMA flowchart is detailed in Figure 1 . Retrospective case series were evaluated with the NICE quality assessment tools (National Institute for Health and Care Excellence), 76 outlined in Table 2 .…”

“…For medially located bristles rather than laterally located bristles, transoral surgery had a higher rate of success by means of lingual tonsillectomy (83.3% success rate) 45,54,57 or pharyngotomy (75% success rate). 17,20,40 There was no significant difference in attempts at, or successful retrieval during, transoral surgery between UADT and DN cases.…”

“…A systematic search was performed per the PRISMA literature selection process ( Figure 1 ). 2-9,12-75 Two authors (N.M. and Y.M.) independently searched the literature for relevant articles.…”

Esophageal Perforation by a Grill Brush Wire Bristle

“…The thin wire bristles are often difficult to detect on imaging studies and patients can have either a negative initial evaluation or a mistaken diagnosis at presentation [ 3 ]. The diagnosis of wire bristle ingestion can be complicated by delayed presentation, non-specific symptoms, and elusive migration of the small object [ 4 ]. Radiographs are a common initial diagnostic test, but these objects are seen only 50% of the time by lateral neck radiographs.…”

“…Various modalities to remove these wire bristles have been suggested in the literature. Esophagoscopy and laryngoscopy allow for the direct visualization of the oropharynx and esophagus, but can miss bristles, particularly when deeply embedded into tissues [ 3 , 4 ]. Depending on the location of the bristle, surgery can be approached transorally or through a cervical incision.…”